18th Amendment : An unfulfilled health prophecy plagues province

ANP-PPP coalition failed to implement its comprehensive health policy.

Noorwali Shah June 09, 2013
Political parties often promote their own provincial health policies while campaigning for elections. PHOTO: FILE


Following the 18th Constitutional Amendment, one of the main strategies employed to improve Khyber-Pakhtunkhwa’s (K-P) health sector during the previous government was a proposed comprehensive health policy.  Unfortunately, however, little came out of it. 

Theory vs. applicability

Political parties often promote their own provincial health policies while campaigning for elections. However, little attention is given to the practicality of these policies.

The previous government’s policy was comprehensive about addressing the health sector’s woes. In addition to defining doctors’ duties and fee structures, the policy also gave details on various ways to improve healthcare. For instance, classifying hospitals according to available facilities so that patients could be referred to the relevant institution for the disease they were suffering from. Furthermore, the policy clearly defined goals for the next few years according to available funding and human resources and also stated where human resources could be increased, how new institutions could be opened, and ways to rectify wrong doings. Among other objectives, the plan suggested increasing the health budget, consulting donors for funding and strengthening public-private partnerships.

However, the Awami National Party(ANP)-Pakistan Peoples Party (PPP) coalition government ultimately failed to implement its ideas. Organisational restructuring of the provincial health department worth Rs944.5 million and the integration of four vertical projects was initiated but could not be completed during the government’s tenure as not all stakeholders were onboard.

Sector-based issues

During the ANP-PPP government, doctors were seen protesting frequently in an attempt to pressure the government into accepting their demands. These demands included service structures, security and higher salaries and proved to be consistent hurdles for patients and medical personnel.

“Forming a policy after the 18th Amendment was the responsibility of K-P, but we did not have the technical experience to do so,” said an official of the health department requesting anonymity. “It is a process that takes months because every department, including finance and planning and development, has to be involved.”

The official added a lack of policy resulted in patients with minor disease now consulting tertiary care hospitals whose main purpose was research and doctor training. “This is because grass root level institutions such as rural health centres and basic health units are not fully functional.”

Shedding light on pertinent issues, the official further said health services require information from all districts so that relevant facilities could be established in various locations. “We do not even have enough information to make a policy because the health department has no standardised information gathering system.”

The case is similar for doctors who have no fixed fee structure and private sector clinics that charge thousands of rupees to treat minor disease. These diseases, unfortunately, take too long to treat in government hospitals.

“Doctors are leaving the country because there is no security for them and the provincial government has failed to chalk out a comprehensive health policy regarding their objectives.  A doctor is appointed at basic pay scale-17 and retires at the same grade after 25 years of service, which is completely unjust,” said Provincial Doctors Association President Dr Abdul Qadir.

Qadir further said if doctors were provided adequate facilities and security in far-flung areas none of the association’s members would refuse to work.

In the wake of forming the new provincial government, the Pakistan Tehreek-e-Insaf (PTI), like its predecessors, has made a plan to improve K-P’s health sector. However, despite the claim that the health sector’s budget will be doubled, the PTI-led government faces a number of problems with very limited resources. Officials in the provincial health department also remain clueless as to how the new government will meet the challenges it promised to solve during its campaign.

Published in The Express Tribune, June 10th, 2013.


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